| National Provider Identifier [NPI]: | 1932384260 |
| Last Name Of The Provider | SULE |
| First Name Of The Provider | JONATHAN |
| Middle Initial Of The Provider | A |
| Credentials Of The Provider | M.D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 3790 OLD U.S. HWY 41 NORTH |
| Street Address 2 Of The Provider | SUITE B |
| City Of The Provider | VALDOSTA |
| Zip Code Of The Provider | 316021398 |
| State Code Of The Provider | GA |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Neurology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 57 |
| Number Of Services | 60063 |
| Number Of Medicare Beneficiaries | 317 |
| Total Submitted Charge Amount | 2792227.79 |
| Total Medicare Allowed Amount | 1414902 |
| Total Medicare Payment Amount | 1099057.89 |
| Total Medicare Standardized Payment Amount | 1119583.81 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 17 |
| Number Of Drug Services | 28839 |
| Number Of Medicare Beneficiaries With Drug Services | 275 |
| Total Drug Submitted ChargeAmount | 159894.79 |
| Total Drug Medicare AllowedAmount | 86112.27 |
| Total Drug Medicare PaymentAmount | 66706.99 |
| Total Drug Medicare Standardized Payment Amount | 66706.99 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 40 |
| Number Of Medical Services | 31224 |
| Number Of Medicare Beneficiaries With Medical Services | 317 |
| Total Medical Submitted Charge Amount | 2632333 |
| Total Medical Medicare Allowed Amount | 1328789.73 |
| Total Medical Medicare Payment Amount | 1032350.9 |
| Total Medical Medicare Standardized Payment Amount | 1052876.82 |
| Average Age Of Beneficiaries | 63 |
| Number Of Beneficiaries Age Less65 | 153 |
| Number Of Beneficiaries Age 65 to 74 | 97 |
| Number Of Beneficiaries Age 75 to 84 | 50 |
| Number Of Beneficiaries Age Greater 84 | 17 |
| Number Of Female Beneficiaries | 199 |
| Number Of Male Beneficiaries | 118 |
| Number Of Non Hispanic White Beneficiaries | 211 |
| Number Of Black or African American Beneficiaries | 91 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | |
| Number Of American Indian Alaska Native Beneficiaries | 0 |
| Number Of Beneficiaries With Race Not Else where Classified | |
| Number Of Beneficiaries With Medicare Only Entitlement | 169 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 148 |
| Percent Of With Atrial Fibrillation | 7 |
| Percent Of With Alzheimers Disease or Dementia | 12 |
| Percent Of With Asthma | 10 |
| Percent Of With Cancer | 6 |
| Percent Of With Heart Failure | 21 |
| Percent Of With Chronic Kidney Disease | 26 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 23 |
| Percent Of With Depression | 35 |
| Percent Of With Diabetes | 46 |
| Percent Of With Hyperlipidemia | 52 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 34 |
| Percent Of With Osteoporosis | 7 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 72 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 4 |
| Percent Of With Stroke | 8 |
| Average HCC Risk Score Of Beneficiaries | 1.9876 |